Summaries of health policy coverage from major news organizations

Study Assesses Care for Pneumonia at California Hospitals

Between 1999 and 2001, more than 200,000 California adults were admitted to 406 hospitals statewide for treatment of pneumonia, and 12.2% of those died within 30 days of admission, according to a report released Monday by the Office of Statewide Health Planning and Development, the Contra Costa Times reports. The report, which is the latest in a series of studies conducted as part of the California Hospital Outcomes Program, made no distinction between patients who died while in the hospital and those who died after being released. The report excluded patients who acquired the illness while in the hospital.

According to the Times, the study used a "sophisticated 'risk adjustment' system" to estimate how many pneumonia deaths each hospital should expect and compared that estimate with the actual number. Researchers adjusted for factors such as patient age; pneumonia type; and other patient conditions, such as cancer, liver disease or asthma.

The study found that above-average performing hospitals treated patients quickly by administering antibiotics within three hours of admission and doing immediate cultures of blood and phlegm to determine the type of pneumonia. Above-average hospitals also were more likely to give unvaccinated patients pneumococcal vaccines; advise people on proper nutrition and tell those who smoke to quit because it increases their risk; and provide doctors with regularly updated lists of antibiotic recommendations.

Steven Lubeck, a research scientist who oversaw the report, said, "We're trying to develop an information base so consumers and others can look at these hospital outcomes and make a decision on the best place to go. It's sort of like grading hospitals on a curve." Lubeck added, "Perhaps the greatest value of the report is when hospitals take a look at themselves."

State officials plan to produce follow-up studies on pneumonia treatment approximately every three years to measure improvement.

CHOP studies are intended to help state residents compare hospitals and help officials identify areas where individual facilities need improvement. Previous CHOP studies focused on heart attack patients, and studies comparing outcomes for births and hip fractures are planned for the future (Kleffman, Contra Costa Times, 9/7). The study is available online.

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